DataSheet_1_Risk Prediction Models for Early ICU Admission in Patients With Autoimmune Encephalitis: Integrating Scale-Based Assessments of the Disease Severity.docx

BackgroundIn patients with autoimmune encephalitis (AE), the prediction of progression to a critically ill status is challenging but essential. However, there is currently no standard prediction model that comprehensively integrates the disease severity and other clinical features. The clinical assessment scale in autoimmune encephalitis (CASE) and the modified Rankin Scale (mRS) have both been applied for evaluating the severity of AE. Here, by combining the two scales and other clinical characteristics, we aimed to investigate risk factors and construct prediction models for early critical care needs of AE patients.MethodsDefinite and probable AE patients who were admitted to the neurology department of Tongji Hospital between 2013 and 2021 were consecutively enrolled. The CASE and mRS scores were used to evaluate the overall symptom severity at the time of hospital admission. Using logistic regression analysis, we analyzed the association between the total scores of the two scales and critical illness individually and then we evaluated this association in combination with other clinical features to predict early intensive care unit (ICU) admission. Finally, we constructed four prediction models and compared their performances.ResultsOf 234 patients enrolled, forty developed critical illness and were early admitted to the ICU (within 14 days of hospitalization). Four prediction models were generated; the models were named CASE, CASE-plus (CASE + prodromal symptoms + elevated fasting blood glucose + elevated cerebrospinal fluid (CSF) white blood cell (WBC) count), mRS and mRS-plus (mRS + prodromal symptoms + abnormal EEG results + elevated fasting blood glucose + elevated CSF WBC count) and had areas under the ROC curve of 0.850, 0.897, 0.695 and 0.833, respectively. All four models had good calibrations. In general, the models containing “CASE” performed better than those including “mRS”, and the CASE-plus model demonstrated the best performance.ConclusionOverall, the symptom severity at hospital admission, as defined by CASE or mRS, could predict early ICU admission, especially when assessed by CASE. Adding other clinical findings, such as prodromal symptoms, an increased fasting blood glucose level and an increased CSF WBC count, could improve the predictive efficacy.</p

Additional file 1: of Deficiency of TREK-1 potassium channel exacerbates blood-brain barrier damage and neuroinflammation after intracerebral hemorrhage in mice

Figure S1. (a) Immunofluorescent-stained images of the TREK-1 negative control co-stained with GFAP and DAPI. (b) The expression of TREK-1 in neurons was detected using immunofluorescent staining. (c-d) PCR and WB genotyping results of WT mice and TREK-1−/− mice. (e-f) The full image containing the target band (TREK-1, GAPDH) with molecular weight markers. Figure S2. (a) Statistical analysis of ipsilateral brain water content in the ICH group compared to the sham group. (b-c) The full images containing the target band (AQP4, β-actin) with molecular weight markers. Figure S3. The full images containing the bands MMP9 (a), claudin-5 (b), occluding (c), ZO-1 (d) with molecular weight markers. Figure S4. (a) Co-staining of MPO negative control with DAPI. (b) Immunofluorescence staining of Iba-1 negative control with DAPI. (c) Immunofluorescent staining of TUNEL negative control co-stained with NeuN and DAPI.Scale bar = 50μm. (d) Cover image for this issue. Table S1. A detailed list of the mice used in different groups in this study. Table S2. A detailed catalog of antibodies and reagents used in this study including the manufacturer, working concentration, and the catalog number. (PDF 838 kb